M A de Graaf1, M L Antoni1, M M Ter Kuile2, M S Arbous3, A J F Duinisveld4, M C W Feltkamp5, G H Groeneveld6, S C H Hinnen7, V R Janssen1, W M Lijfering8, S Omara1, P E Postmus4, S R S Ramai4, N Rius-Ottenheim9, M J Schalij1, S K Schiemanck10, L Smid6, J L Stöger11, L G Visser6, J J C de Vries5, M A Wijngaarden12, J J M Geelhoed4, A H E Roukens6. 1. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands. 2. Department of Gynaecology, Leiden University Medical Center, the Netherlands. 3. Department of Intensive Care, Leiden University Medical Center, the Netherlands. 4. Department of Pulmonary Diseases, Leiden University Medical Center, the Netherlands. 5. Department of Medical Microbiology, Leiden University Medical Center, the Netherlands. 6. Department of Infectious Diseases, Leiden University Medical Center, the Netherlands. 7. Department of Oncology, Leiden University Medical Center, the Netherlands. 8. Department of Clinical Epidemiology, Leiden University Medical Center, the Netherlands. 9. Department of Psychiatry, Leiden University Medical Center, the Netherlands. 10. Department of Rehabilitation Medicine, Leiden University Medical Center, the Netherlands. 11. Department of Radiology, Leiden University Medical Center, the Netherlands. 12. Department of Internal Medicine, section Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
Abstract
BACKGROUND: Short-term follow-up of COVID-19 patients reveals pulmonary dysfunction, myocardial damage and severe psychological distress. Little is known of the burden of these sequelae, and there are no clear recommendations for follow-up of COVID-19 patients.In this multi-disciplinary evaluation, cardiopulmonary function and psychological impairment after hospitalization for COVID-19 are mapped. METHODS: We evaluated patients at our outpatient clinic 6 weeks after discharge. Cardiopulmonary function was measured by echocardiography, 24-hours ECG monitoring and pulmonary function testing. Psychological adjustment was measured using questionnaires and semi-structured clinical interviews. A comparison was made between patients admitted to the general ward and Intensive care unit (ICU), and between patients with a high versus low functional status. FINDINGS: Eighty-one patients were included of whom 34 (41%) had been admitted to the ICU. New York Heart Association class II-III was present in 62% of the patients. Left ventricular function was normal in 78% of patients. ICU patients had a lower diffusion capacity (mean difference 12,5% P = 0.01), lower forced expiratory volume in one second and forced vital capacity (mean difference 14.9%; P<0.001; 15.4%; P<0.001; respectively). Risk of depression, anxiety and PTSD were 17%, 5% and 10% respectively and similar for both ICU and non-ICU patients. INTERPRETATION: Overall, most patients suffered from functional limitations. Dyspnea on exertion was most frequently reported, possibly related to decreased DLCOc. This could be caused by pulmonary fibrosis, which should be investigated in long-term follow-up. In addition, mechanical ventilation, deconditioning, or pulmonary embolism may play an important role.
BACKGROUND: Short-term follow-up of COVID-19 patients reveals pulmonary dysfunction, myocardial damage and severe psychological distress. Little is known of the burden of these sequelae, and there are no clear recommendations for follow-up of COVID-19 patients.In this multi-disciplinary evaluation, cardiopulmonary function and psychological impairment after hospitalization for COVID-19 are mapped. METHODS: We evaluated patients at our outpatient clinic 6 weeks after discharge. Cardiopulmonary function was measured by echocardiography, 24-hours ECG monitoring and pulmonary function testing. Psychological adjustment was measured using questionnaires and semi-structured clinical interviews. A comparison was made between patients admitted to the general ward and Intensive care unit (ICU), and between patients with a high versus low functional status. FINDINGS: Eighty-one patients were included of whom 34 (41%) had been admitted to the ICU. New York Heart Association class II-III was present in 62% of the patients. Left ventricular function was normal in 78% of patients. ICU patients had a lower diffusion capacity (mean difference 12,5% P = 0.01), lower forced expiratory volume in one second and forced vital capacity (mean difference 14.9%; P<0.001; 15.4%; P<0.001; respectively). Risk of depression, anxiety and PTSD were 17%, 5% and 10% respectively and similar for both ICU and non-ICU patients. INTERPRETATION: Overall, most patients suffered from functional limitations. Dyspnea on exertion was most frequently reported, possibly related to decreased DLCOc. This could be caused by pulmonary fibrosis, which should be investigated in long-term follow-up. In addition, mechanical ventilation, deconditioning, or pulmonary embolism may play an important role.
Authors: Aditi S Shah; Min Hyung Ryu; Cameron J Hague; Darra T Murphy; James C Johnston; Christopher J Ryerson; Christopher Carlsten; Alyson W Wong Journal: ERJ Open Res Date: 2021-09-13
Authors: Destin Groff; Ashley Sun; Anna E Ssentongo; Djibril M Ba; Nicholas Parsons; Govinda R Poudel; Alain Lekoubou; John S Oh; Jessica E Ericson; Paddy Ssentongo; Vernon M Chinchilli Journal: JAMA Netw Open Date: 2021-10-01
Authors: Mohammad Said Ramadan; Lorenzo Bertolino; Rosa Zampino; Emanuele Durante-Mangoni Journal: Clin Microbiol Infect Date: 2021-06-23 Impact factor: 13.310